Antonio Maria Rapisarda

Background: Wrist arthritis significantly impacts the quality of life in elderly populations. While total wrist arthroplasty and wrist arthrodesis are established treatments, partial resurfacing procedures are emerging as a solution offering advantages for patients over 70 years of age. Objective: To systematically evaluate the efficacy, safety, and functional outcomes of radial versus carpal resurfacing procedures for the management of wrist arthritis in patients over 70 years of age. Methods: A comprehensive search of PubMed, Scopus, and Web of Science was conducted for studies published from these databases’ inception to May 2025. Studies reporting the outcomes of either radial or carpal resurfacing in patients ≥70 years of age with wrist arthritis were included. Primary outcomes were pain reduction, functional improvement, and complication rates. Results: Twenty studies met the inclusion criteria. Both carpal and radial resurfacing provided pain relief, with mean VAS scores ranging from 0 to 3.8 across studies and DASH scores ranging from 13 to 59 points, while carpal resurfacing showed better preservation of range of motion, with flexion/extension arcs of 27–65° compared to 22–46° for radial implants. Complication rates were comparable, though implant loosening was uncommon with both radial and carpal resurfacing. Both procedures demonstrated satisfactory patient-reported outcomes at midterm follow-up (median: 32 months; range: 6–84 months). Conclusion: In patients over 70 years of age with wrist arthritis, both radial and carpal resurfacing appear to be viable options with distinct advantages. Radial resurfacing may be preferred for patients with previous distal radius fractures, while carpal resurfacing offers better motion preservation and is indicated in SLAC and SNAC wrists. Patient selection should consider specific arthritis patterns, activity requirements, and comorbidities. Long-term studies are needed to evaluate durability beyond 5–10 years in this population.

Background: Primary lymphoma of peripheral nerves (PLPN) is a rare extranodal non-Hodgkin lymphoma that mimics benign nerve conditions, leading to diagnostic delays. This systematic review evaluates the clinical, radiological, and pathological features of PLPN, alongside diagnostic and therapeutic strategies. Materials and Methods: A systematic search was conducted across PubMed, Scopus, and Web of Science, and identified 23 studies reporting 27 cases of PLPN. Data on demographics, clinical presentation, diagnostics, treatment, and outcomes were extracted and synthesized qualitatively due to study heterogeneity. Results: The sciatic nerve was most involved (48.15%), followed by the ulnar (18.5%) and radial nerves (18.5%). The median age at diagnosis was 58 years, with symptoms including motor deficits (88.9%), sensory disturbances (74.1%), and pain (70.4%). B-cell lymphomas accounted for 81.5% of cases, predominantly diffuse large B-cell lymphoma. MRI findings were non-specific; however, diffusion-weighted imaging (DWI) showed diagnostic potential. Treatments included combination therapies (51.9%), chemotherapy (25.9%), and surgery. Complete remission was achieved in 70.8%, with a 2-year survival rate of 83.3%. Conclusions: PLPN is rare but likely underdiagnosed. Early recognition requires multidisciplinary collaboration, advanced imaging, and standardized protocols. Future research should focus on molecular characterization, diagnostic criteria, and treatment optimization to improve outcomes for this challenging condition.